Provider Demographics
NPI:1154589877
Name:MEOLA, NICOLE MARIA (RN, MS,RNFA)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:MARIA
Last Name:MEOLA
Suffix:
Gender:F
Credentials:RN, MS,RNFA
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:MARIA
Other - Last Name:MEOLA-BURKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN,MS,RNFA
Mailing Address - Street 1:15 W LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8105
Mailing Address - Country:US
Mailing Address - Phone:856-810-3970
Mailing Address - Fax:
Practice Address - Street 1:15 W LAKE RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-8105
Practice Address - Country:US
Practice Address - Phone:856-810-3970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNO092853163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant